Despite concerns over the sluggish economy and changing payment models, hospitals and health systems are making big investments in electronic medical records, earmarking significant portions of their capital spending dollars to implement these expensive systems in the hope of improving their ability to manage population health.

The irony is not lost on providers, who are well aware that they are investing vast amounts of money in an IT project that will allow them to provide better coordinated care for which the government and commercial payers intend to pay less. Yet most believe enhancing their collection and use of patient data is the only way to move forward in the pursuit of better care delivery.

Investing in an EMR is also a smart move in light of Medicare's shifting reimbursement structure. Hospital executives believe the return on investment in an EMR will come from better care coordination, more streamlined clinical processes, improved patient satisfaction, and lower readmission rates—all of which will result in healthier Medicare payments.

"We're in the process of implementing a new computer system—electronic medical record—it's our biggest single expenditure," says John Heye, senior vice president for finance and CFO at Maine Medical Center, a 600-bed hospital in Portland and the largest entity in the MaineHealth integrated health system. "All told, we'll spend $61 million."

Heye says Maine Medical Center plans to pay for the EMR out of capital equity but will also consider other options. "This year we are starting to reevaluate our strategy and see where the rates are."

The strategic thinking behind the EMR implementation is to "focus more on accountable care and population health management," says Heye, noting that the EMR will allow the health system to transfer information quickly and efficiently between providers once the technology is up and running throughout MaineHealth, which covers 11 counties in Maine. Heye expects the rollout process to take up to 24 months.